PAHO dispels myths about the handling and the effects of mass casualties

The Pan American Health Organization (PAHO) has published a new manual that dispels myths about the handling and the effects of mass casualties following a natural disaster, such as the December 26 earthquake and tsunami in South Asia.

The book, Management of Dead Bodies in Disaster Situations, provides the technical information needed to support relief workers in the proper management of dead bodies, based on the following principles:

• When a death is the result of a disaster, the body does not pose a major public health risk for the spread of infection.

• Victims should not be buried in common graves.

• Mass cremation of bodies should not take place when this goes against the cultural and religious norms of the population.

• Every effort should be made to identify bodies, and—as a last resort—unidentified corpses should be buried in such a way as to permit later identification or exhumation. This is a basic human right of surviving family members.

“Regrettably, we continue to be witness to the use of common graves and mass cremations for the rapid disposal of dead bodies owing to the myths and beliefs that corpses pose a high risk of epidemics,” PAHO Director Mirta Roses writes in the book’s foreword. “These measures are carried out without respecting identification processes or preserving the individuality of the deceased.”

“There is no justification from the medico legal standpoint not to follow all scientific procedures for the recovery, transfer, identification and final disposal of the remains of disaster fatalities,” the manual notes. The book recommends that “a select group of experts who are experienced in these procedures should oversee the process.”

The manual points to other misguided measures often triggered by fears that corpses could transmit disease or generate epidemics, including widespread vaccination.

The book acknowledges that certain infectious diseases do pose a small threat to those directly charged with handling dead bodies. These include tuberculosis, strep, hepatitis B and C, and HIV. The book offers guidance on protective measures to avoid contagion.

Myths about the treatment of the dead are strongly rooted in culture and history, the book notes. Karl Western, of the U.S. National Institutes of Health, writing in one of the manual’s chapters, traces the origins of the myths to great epidemics such as the 14th century plague epidemic in Europe. Known as the “Black Death,” it claimed an estimated 25 million people, or one-third of Europe’s population. The experience, he notes, “gave rise to the appearance of many of the myths concerning corpses.”

The 176-page manual, published in late 2004, was developed by PAHO’s Area on Emergency Preparedness and Disaster Relief as “a tool to be used by national and local authorities and professionals from public institutions that are affected” by natural disasters.

PAHO was established in 1902 and is the world’s oldest public health organization. PAHO works with all the countries of the Americas to improve the health and the quality of life of people of the Americas. It serves as the Regional Office for the Americas of the World Health Organization (WHO).

PAHO Member States today include all 35 countries in the Americas. France, the Kingdom of the Netherlands, and the United Kingdom of Great Britain and Northern Ireland are Participating States. Portugal and Spain are Observer States, and Puerto Rico is an Associate Member.